title: Pretreatment serum concentrations of 25-hydroxyvitamin D and breast cancer prognostic characteristics: a case-control and a case-series study.
abstract: BACKGROUND
  Results from epidemiologic studies on the relationship between vitamin D and breast cancer risk are inconclusive. It is possible that vitamin D may be effective in reducing risk only of specific subtypes due to disease heterogeneity.
  
  
  RESULTS
  In case-control and case-series analyses, we examined serum concentrations of 25-hydroxyvitamin D (25OHD) in relation to breast cancer prognostic characteristics, including histologic grade, estrogen receptor (ER), and molecular subtypes defined by ER, progesterone receptor (PR) and HER2, among 579 women with incident breast cancer and 574 controls matched on age and time of blood draw enrolled in the Roswell Park Cancer Institute from 2003 to 2008. We found that breast cancer cases had significantly lower 25OHD concentrations than controls (adjusted mean, 22.8 versus 26.2 ng/mL, p<0.001). Among premenopausal women, 25OHD concentrations were lower in those with high- versus low-grade tumors, and ER negative versus ER positive tumors (p≤0.03). Levels were lowest among women with triple-negative cancer (17.5 ng/mL), significantly different from those with luminal A cancer (24.5 ng/mL, p = 0.002). In case-control analyses, premenopausal women with 25OHD concentrations above the median had significantly lower odds of having triple-negative cancer (OR = 0.21, 95% CI = 0.08-0.53) than those with levels below the median; and every 10 ng/mL increase in serum 25OHD concentrations was associated with a 64% lower odds of having triple-negative cancer (OR = 0.36, 95% CI = 0.22-0.56). The differential associations by tumor subtypes among premenopausal women were confirmed in case-series analyses.
  
  
  CONCLUSIONS
  In our analyses, higher serum levels of 25OHD were associated with reduced risk of breast cancer, with associations strongest for high grade, ER negative or triple negative cancers in premenopausal women. With further confirmation in large prospective studies, these findings could warrant vitamin D supplementation for reducing breast cancer risk, particularly those with poor prognostic characteristics among premenopausal women.
authors.affiliation: Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York, United States of America. song.yao@roswellpark.org
authors.forename: Song
authors.initials: S
authors.lastname: Yao
authors.forename: Lara E
authors.initials: LE
authors.lastname: Sucheston
authors.forename: Amy E
authors.initials: AE
authors.lastname: Millen
authors.forename: Candace S
authors.initials: CS
authors.lastname: Johnson
authors.forename: Donald L
authors.initials: DL
authors.lastname: Trump
authors.forename: Mary K
authors.initials: MK
authors.lastname: Nesline
authors.forename: Warren
authors.initials: W
authors.lastname: Davis
authors.forename: Chi-Chen
authors.initials: CC
authors.lastname: Hong
authors.forename: Susan E
authors.initials: SE
authors.lastname: McCann
authors.forename: Helena
authors.initials: H
authors.lastname: Hwang
authors.forename: Swati
authors.initials: S
authors.lastname: Kulkarni
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Edge
authors.forename: Tracey L
authors.initials: TL
authors.lastname: O'Connor
authors.forename: Christine B
authors.initials: CB
authors.lastname: Ambrosone
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D002277:Carcinoma / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009994:Osmolar Concentration; D017698:Postmenopause / Q000097:blood / Q000502:physiology; D017697:Premenopause / Q000097:blood / Q000502:physiology; D011379:Prognosis; D018570:Risk Assessment; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000032:analysis / Q000097:blood
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D